Test Summary Sheet for:

Purpose
Exclusion Screen
Method(s)
Gas Chromatography (GC)
Suggested CPT Code(s)
80307
New York State Approval Status

Approved

Known Interference(s)
Protriptyline [GC]: Desmethylsertraline (Sertraline metabolite); Norcyclobenzaprine (Cyclobenzaprine metabolite)
Turnaround Time

8 days (If Positive: 15 days)

Test Includes
1 Protriptyline Vivactil® Gas Chromatography (GC) ng/mL 10 Antidepressant Desmethylsertraline (Sertraline metabolite); Norcyclobenzaprine (Cyclobenzaprine metabolite)

Test Also Known As
Triptil®
Reflex Tests
Test Code Test Name
5566B Protriptyline Confirmation, Blood
Specimen Type
Blood
Requested Volume
10 mL
Minimum Volume
4.8 mL
Special Handling
None
Specimen Container
Lavender top tube (EDTA)

Additional Collection Instructions

Transport Temperature
Refrigerated
Light Protection
Not Required
Rejection Criteria
None

Rejection criteria pertain to clinical specimen submissions only.

Stability
Room Temperature: 14 day(s)
Refrigerated: 14 day(s)
Frozen (-20 °C): 12 month(s)
1 Protriptyline Vivactil® Gas Chromatography (GC) ng/mL 10 Antidepressant Desmethylsertraline (Sertraline metabolite); Norcyclobenzaprine (Cyclobenzaprine metabolite)

Interface Map

LOINC® Information

The CPT Codes provided in this document are based on AMA Guidelines and are for informational purposes only. NMS Labs Does not assume responsibility for billing errors due to Reliance on the CPT Codes listed in this document.

*The information contained in this document represents database configurations, as they will appear on the effective date listed above.